Repeatability and accuracy of a non-invasive method of measuring internal and external rotation of the tibia

Russell, David F.; Deakin, A.H.; Fogg, Quentin A.; Picard, F.

doi:10.1007/s00167-013-2812-5

Cited by 10 publications

(9 citation statements)

References 56 publications

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“…Unfortunately, the position of the foot in internal/external rotation is not correlated with the position of the tibial tubercle. This finding matches the results of previous studies that have shown that the rotation of the foot is not an accurate measure tibial rotation [ 2 , 3 , 26 ]. This does not mean that lower leg rotation as measured by foot position is not valuable.…”

Section: Discussionsupporting

confidence: 92%

The use of a robotic tibial rotation device and an electromagnetic tracking system to accurately reproduce the clinical dial test

Stinton¹,

Siebold

Freedberg

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to: (1) determine whether a robotic tibial rotation device and an electromagnetic tracking system could accurately reproduce the clinical dial test at 30° of knee flexion; (2) compare rotation data captured at the footplates of the robotic device to tibial rotation data measured using an electromagnetic sensor on the proximal tibia. MethodsThirty-two unilateral ACL-reconstructed patients were examined using a robotic tibial rotation device that mimicked the dial test. The data reported in this study is only from the healthy legs of these patients. Torque was applied through footplates and was measured using servomotors. Lower leg motion was measured at the foot using the motors. Tibial motion was also measured through an electromagnetic tracking system and a sensor on the proximal tibia. Load-deformation curves representing rotational motion of the foot and tibia were compared using Pearson’s correlation coefficients. Off-axis motions including medial–lateral translation and anterior–posterior translation were also measured using the electromagnetic system. ResultsThe robotic device and electromagnetic system were able to provide axial rotation data and translational data for the tibia during the dial test. Motion measured at the foot was not correlated to motion of the tibial tubercle in internal rotation or in external rotation. The position of the tibial tubercle was 26.9° ± 11.6° more internally rotated than the foot at torque 0 Nm. Medial–lateral translation and anterior–posterior translation were combined to show the path of the tubercle in the coronal plane during tibial rotation.ConclusionsThe information captured during a manual dial test includes both rotation of the tibia and proximal tibia translation. All of this information can be captured using a robotic tibial axial rotation device with an electromagnetic tracking system. The pathway of the tibial tubercle during tibial axial rotation can provide additional information about knee instability without relying on side-to-side comparison between knees. The translation of the proximal tibia is important information that must be considered in addition to axial rotation of the tibia when performing a dial test whether done manually or with a robotic device. Instrumented foot position cannot provide the same information. Level of evidenceIV.

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Section: Discussionsupporting

confidence: 92%

The use of a robotic tibial rotation device and an electromagnetic tracking system to accurately reproduce the clinical dial test

Stinton¹,

Siebold

Freedberg

et al. 2016

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Utilising standard anatomical landmarks, the computer designs a three-dimensional (3D) image of the anatomy [ 15 ]. CAOS provides dynamic and real-time assessment of femoral-tibial mechanical axis (FTMA), measurements of coronal and sagittal knee alignment offering a potential alternative to radiographs [ 16 ], tibial rotational profile [ 17 ] and knee kinematics [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Computer assisted navigation in total knee and hip arthroplasty

Deep

Shankar

Mahendra

2017

SICOT-J

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Introduction: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. Methods: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction. Results: Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years. Conclusion: Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a standard practice in the future in various forms like navigation or robotics.

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“…Therefore, proper initial tension of the graft during ACL reconstruction is crucial. Some methods and devices have been developed to measure initial graft tension, but it is di cult to apply these devices in vivo [27][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Development and application of the online initial graft tension measurement system for anterior cruciate ligament reconstruction

Chen

Zhao

Liao

et al. 2023

Preprint

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The initial graft tension during ACL reconstruction is an essential mechanical parameter. We established a viscoelastic lateral mechanical measurement model. Based on this model, we designed the online measurement system for the initial graft tension during ACL reconstruction. 22 patients with chronic ACL deficiency were treated by single-bundle ACL reconstruction. 12 patients underwent single-bundle ACL reconstruction (group 1), whereas 10 underwent single-bundle ACL reconstruction using the online tension measurement system (group 2). All patients were followed up with the Lysholm score and International Knee Documentation Committee (IKDC) score to evaluate knee joint function. The Lysholm scores and the IKDC scores of the two groups were significantly higher at 1 month and 3 months after the operation with a significant difference, and the Lysholm scores and the IKDC scores of the instrument group (group 2) was significantly higher than those of the control group with significant difference (group 1). In the same ACL single-bundle reconstruction, the application of the online initial graft tension measurement system can provide quantification for the initial graft tension of ACL, improving the current situation in which only experience can be used to estimate the initial graft tension.

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Repeatability and accuracy of a non-invasive method of measuring internal and external rotation of the tibia

Cited by 10 publications

References 56 publications

The use of a robotic tibial rotation device and an electromagnetic tracking system to accurately reproduce the clinical dial test

The use of a robotic tibial rotation device and an electromagnetic tracking system to accurately reproduce the clinical dial test

Computer assisted navigation in total knee and hip arthroplasty

Development and application of the online initial graft tension measurement system for anterior cruciate ligament reconstruction

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